Surgery Complications & FMLA

We have an employee who had back surgery and was out on FMLA for several weeks and is currently working a part time schedule puttng her on intermittent FMLA.  She just notified me that she had an eye/nerve complication from the surgery. She has an appointment on Monday for an outpatient procedure that will be able to correct part of the issue with plastic surgery.  My question is how do I handle this in terms of FMLA and what additional paperwork do I need to request?  Is this covered under the initial medical certification or do I need to ask her plastic surgeon to fill out another cert for the one day appointment?  I have listed specific dates below.

She went to the eye doctor on 07/13/2010- told her she would need plastic surgery to correct issue.

She has an outpatient appt. on 07/19/2010- for plastic surgery

I am confused because she will be seeing two other doctors besides her back surgeon and will be missing two extra days of work for these appoitments.


  • 4 Comments sorted by Votes Date Added
  • Here is what I would do and why.

    First the FMLA year of 12 workweeks and what ever the hours are that she works in those 12 workweeks, has already been triggered by the back surgery. The additional doctor's appointment does not begin a new FMLA year unless you are using a calendar year and the calendar year will expire. The other medical problems will be captured in the same FMLA year.

    However the conditions of her medical certification for her qualified FMLA  absence have significantly changed. The changes are the two 'new' though perhaps associated medical conditions. Though you really do not need to revisit the conditions of the back surgery, unless I'm missing something, you do need to send a medical certification to the primary care medical provider for the changed condition regarding the eye condition. The question is who will that primary care provider be? The eye doctor and the visits may qualify under FMLA as a serious health condition if it is treatment involving inpatient  care or continuous treatment. So I would send a medical certification to the eye doctor.

    The plastic surgery under FMLA is bit trickier. <29 CFR 825.113(d)> Normally plastic surgery  is not qualified under FMLA unless complications develop from an inpatient procedure; the plastic surgery is restorative after an injury or removal of a cancerous growth, that is if the other conditions of FMLA are met. To me the other two issues are relatively easy to settle. The plastic surgery as handled under FMLA is something you will have to consider according to the seriousness of the medical condition. The eye doctor's medical certification can be a tremendous help in that regard.

    Lastly. Seeing multiple doctors really does not change the FMLA year or the expectations of return nor does it extend the FMLA hours. It is still 12 workweeks in your FMLA  year. If the conditions meet FMLA medical qualifications certify them as FMLA absences and deduct the time accordingly. Each certified absences is deducted from the 12 workweek FMLA allotment.

  • THe FMLA regulation is on cosmetic surgery, not plastic surgery, isn't it?  If I recall correctly, this is not cosmetic surgery.  It is surgery performed by a plastic surgeon which could, for example, be to re-shape the flesh around an eye for functional rather than cosmetic purposes.
  • Both terms are used in the regulation. Cosmetic surgery is treated differently under the regulation than restorative plastic surgery. I apologize if I did not make that clear. TX is correct to point out the difference.

     Since your explanation of the circumstances seems to suggest that this could be restorative surgery,  I would send a med cert to that provider as well.

    Thanks TX [Y] 

  • Thank you all very much for your help!
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